Comprehensive Agreement Research Articles

Organizational health literacy strength and learning opportunities in Italian hospitals

Abstract Background Organizational Health Literacy (OHL) implies responsiveness and friendliness of healthcare organizations. In the context of the WHO Action Network M-POHL, Italy evaluated OHL in a hospital as a pilot. Methods The international self-assessment tool OHL-Hos explores 8 standards using 141 items. It was firstly translated and culturally adapted to Italy, and then tested to assess OHL in the public general hospital of Pistoia (Central Italy). A physician, 6 staff members of the healthcare management unit, and 3 medical residents in public health from the Florence University were involved in the pilot. The Pistoia hospital has 1,300 employees (44% nurses, 24% physicians) to face 18,000 hospitalizations per year. Results Completing the questionnaire took more than 5 hours. A comprehensive agreement was reached, even though different approaches aiming at improving HL in healthcare and non-healthcare staff emerged. Scores resulted acceptable/good for standard 5 (communication with patients) and 7 (promoting staff HL with regard to occupational risks and personal lifestyles), low for standards 1 (implementing OHL overall the hospital), 2 (involving stakeholders in developing documents, materials, services), 3 (staff training for personal and organizational HL) and 8 (contributing to local population personal HL improvement), which would apply more peculiar for other settings than hospitals. Conclusions The participation of the hospital working group in the assessment using the OHL-Hos raised interest toward this matter. It results time consuming for its excessive length, and some standards do not fit to the Italian hospital context, resulting more useful to assess the territorial organization. Reduction of the number of items and revision/reformulation of some of them are suggested. Nonetheless, the tool proved to be useful in indicating the most critical areas needing ad hoc interventions, such as training all the hospital staff.

Between the ballot and the bullet: rebel-to-party transformations and the structure of the competitive field

ABSTRACT When rebel groups transition to electoral parties and participate in the democratic process, the prospects of peace are often fragile. We argue that rebel parties’ capacity to effectively participate in the electoral arena and contribute to post-conflict stability is contingent on the nature and legacies of the wartime competitive field. Where rebels and politicians shared claims of representation over their constituents in wartime, we argue that elections-related violence is likely in postwar elections when the rebels transition towards political parties. These former rebel parties challenges established electoral holds of political actors who previously represented the community at the ballot box while collaborating with insurgents. The transformation from wartime allies to direct electoral competition creates new incentives for violence, especially where violence is already normalized. Conversely, where established politicians maintain hegemonic representation of their constituency, they create strong barriers to entry for former insurgents in the electoral realm. As a result, the incentives for violence are much reduced. We analyse the Moro Islamic Liberation Front’s transformation into the United Bangsamoro Justice Party after the Comprehensive Agreement on the Bangsamoro.

Power Over Presence: Women’s Representation in Comprehensive Peace Negotiations and Gender Provision Outcomes

The Women, Peace, and Security (WPS) sector assumes increasing the number of women involved in peace negotiations drives better outcomes for local women. However, empirical support for this assumption is inconsistent. This article tests how power alters the relationship between women’s formal (Track 1) involvement in peace negotiations and the inclusion of women-specific provisions in peace agreements. Using an original dataset comprised of 2,299 Track 1 delegates involved in 116 comprehensive peace agreements finalized between 1990 and 2021, I find women’s involvement in peace negotiations is positively correlated to comprehensive agreements containing provisions for women. However, this correlation is dependent on women holding positions of power—simply having women in the room is insufficient. This article offers a novel quantitative approach to WPS studies, provides nuance to theories linking descriptive and substantive representation, and casts doubt on the longstanding assumption that increasing women’s involvement inherently enhances gender equality.

EU–China Comprehensive Agreement on Investment: The impact of firm supply chains on firm value

This research adopts an event study approach to investigate the impact of the European Union (EU)–China Comprehensive Agreement on Investment (CAI) negotiations on firm value. We emphasise two typical events during the process, i.e. the preliminary agreement and the suspension of the CAI, which result in completely distinct patterns of policy uncertainty for the EU and China. Using data from Chinese listed firms, we find that the Chinese stock market reacts positively to the preliminary agreement of the CAI but negatively to its suspension. A firm with global supply chains has better stock returns when exposed to the first event but no significant heterogeneity under the second event. We also find that these effects vary depending on the overseas experience of the CEO, firm ownership type, and whether the firm is in a high-tech industry.

America's Iran Policy Pendulum from Obama and Trump to Biden (2009-2022): Between Diplomatic Engagement and Maximum Pressure

Objectives: This study examines US policy towards Iran from 2009 to 2022, focusing on the challenges and tools utilized by successive US administrations. Methods: The study adopts a descriptive and analytical approach, drawing on official US documents, presidential statements, relevant articles, reports, and research. Results: US-Iranian relations faced significant obstacles due to Iran's regional behavior and interference in other countries' affairs, leading to political instability. Different administrations employed varying strategies, with Obama pursuing a mix of diplomacy and economic sanctions, while the Trump administration opted for a strict approach, including withdrawing from the nuclear agreement and re-imposing economic sanctions. The Biden administration has continued the pressure by reinstating sanctions and expressing a desire to negotiate a new comprehensive agreement. Conclusion: Despite inconsistencies, the overarching goal of US policy remains influencing Iran to alter its regional policies. However, these efforts have not produced a notable change in Iranian behavior, impeding the improvement of US-Iranian relations.

Washington’s hesitancy on digital-trade diplomacy

A group of 81 countries reached a negotiating milestone in July 2024 on measures they might take to reduce barriers to trading digital goods and on cross-border data flows. The United States did not join them, however, due to concerns over security and maintaining regulatory autonomy. It will take further negotiations for the parties to reach a comprehensive agreement that can be implemented, a process that will likely take years, but US resistance casts some doubt on whether a broad global push to reform long-outdated digital-trade rules can succeed.

A novel quantitative method to evaluate lumbar disc degeneration: MRI histogram analysis.

This study aimed to use MRI histogram analysis to routine MRI sequences to evaluate lumbar disc degeneration (LDD), illustrate the correlation between this novel method and the traditional Pfirrmann classification method, and more importantly, perform comprehensive agreement analysis of MRI histogram analysis in various situations to evaluate its objectivity and stability. Lumbar MRI images from 133 subjects were included in this study. LDD was classified into grades by Pfirrmann classification and was measured as peak separation value by MRI histogram analysis. Correlation analysis between the two methods was performed and cutoff values were determined. In addition, the agreement analysis of peak separation value was performed by intraclass correlation coefficient (ICC) in four scenarios, including inter-resolution, inter-observer, inter-regions of interest (ROI) and inter-slice. Peak separation values were strongly correlated with Pfirrmann grades (r = - 0.847). The inter-resolution agreements of peak separation value between original image resolution of 2304 × 2304 and compressed image resolutions (1152 × 1152, 576 × 576, 288 × 288) were good to excellent (ICCs were 0.916, 0.876 and 0.822), except 144 × 144 was moderate (ICC = 533). The agreements of inter-observer (ICC = 0.982) and inter-ROI (ICC = 0.915) were excellent. Compared with the mid-sagittal slice, the inter-slice agreements were good for the first adjacent slices (ICCs were 0.826 and 0.844), and moderate to good for the second adjacent slices (ICC = 0.733 and 0.753). MRI histogram analysis, used in routine MRI sequences, demonstrated a strong correlation with Pfirrmann classification and good agreements in various scenarios, expanding the range of application and providing an effective, objective and quantitative tool to evaluate LDD.

Surrogacy: An important pathway to parenthood. A call for international standardization

This comprehensive review examines the multifaceted landscape of surrogacy, a revolutionary treatment for infertility. The study examines historical origins, shifting trends, medical considerations, psychological implications, legal complexities, international variations, and ethical dilemmas surrounding surrogacy. With the advent of assisted reproductive technology, gestational surrogacy allows intended parents a genetic connection to their child. Medical facets encompass indications for gestational surrogacy, drawing attention to maternal health risks and infertility factors. Evidence indicates that medical outcomes are comparable to conventional pregnancies, suggesting a viable reproductive solution for intended parents. Due to the complex nature of surrogacy psychological and emotional vulnerability is inevitable; yet studies underscore positive psychological well-being and satisfaction among gestational carriers (GCs), intended parents (IPs) and children. Surrogacy also has many religious dimensions, as each religion has its own perspective on the distinctive process of creating life and its outcomes, such as, the determination of the child's mother according to their beliefs. Legal considerations emerge as a fundamental aspect, with differing regulations globally. The review emphasizes the significance of comprehensive agreements to safeguard the rights and responsibilities of surrogates and IPs. The unique surrogacy laws in Israel serve as a noteworthy example, reflecting a progressive approach that provides a promising template to establish crucial international guidelines on surrogacy. The absence of international consensus necessitates attention from the global community to address key concerns, including the well-being of GCs, legal recognition for IPs, and the child's best interests, with the goal of establishing a universal standard of care in the field.

《数据论文出版元数据》国家标准研制与实践

In August 2023, the national standard for GB/T 42813-2023 Data paper publication metadata was officially released. This standard specifies the content and framework of metadata required for data paper publication, including dataset metadata, data paper metadata, as well as their description methods, extension principles, and methods. It is applicable to the description, preservation, online publishing, and sharing services associated with data papers and their corresponding datasets. The release of this standard marks the first comprehensive agreement at the national level regarding the new mode of data paper publishing, namely the open sharing of scientific data, which has addressed the prior absence of standardized guidance in the field of data publishing. It facilitates data publishing institutions in promptly releasing data papers and their associated data, providing support for the rights and protection of scientific data. The standard holds significant importance in promoting the establishment of an open and shared ecosystem for scientific data. Since its publication, certain data journals or scientific data publishing platforms have begun adopting the elements and definitions specified in the standard, thus engaging in a more extensive practice.

Critical analysis of the new Chinese foreign investment law in the prism of China-EU CAI and China-US bit negotiations

The Chinese foreign direct investment legal system prior to 2019 evolved constantly, although it failed to satisfactorily address the main issues for foreign direct investments. The new Chinese Foreign Investment Law of 2019 and its Implementing Rule made a landmark improvement to the legal system. This new reform went hand in hand with the China-EU Comprehensive Agreement on Investment (CAI) and China-US BIT and their negotiations. It played a preparative role for the progress made in these two influential investment agreements. It offered unprecedent solutions in areas such as the pre-establishment national treatment, prohibition of forced technology transfer and the enhanced foreign investment protection. Nonetheless, further reforms on SOEs are still needed. The ratification of the China-EU CAI and the reanimation of the China-US BIT, albeit unlikely to happen anytime soon, would still provide long-desired clarity to the dispute resolution mechanism, national security review system and forced technology transfer issue.

WTO 수산보조금협정에 관한 소고

Negotiations on the norms regulating fisheries subsidies were launched within the WTO framework as part of the Doha Development Agenda in 2001, and have been ongoing for over 20 years. The Agreement on Fisheries Subsidies was finalized at the 12th Ministerial Conference in June 2022.
 The Agreement is a significant outcome of more than two decades of negotiations on fisheries subsidies. It is the first multilateral agreement to recognize that certain trade policies, such as subsidies, can have harmful impacts on the world’s marine environment, and to address the environmental issue of marine sustainability in the WTO framework by building a harmonized and interrelated relationship among trade, environment, and development. This is significant because multilateral norms on subsidies are not limited to marine resource sustainability. The WTO Members are currently exploring the appropriate role and function of subsidies in the design of policies to effectively reduce greenhouse gas emissions from domestic industries, especially as they face the challenge of combating climate change. This is because climate change response policies using subsidies may fall within the scope of the WTO Subsidies Agreement and be subject to countervailing measures, whereas fuel subsidies that are harmful to the environment may not be regulated as they do not meet the specificity requirement. Under these circumstances, the Agreement shows that it is possible for the Members to agree on trade norms for sustainable development in response to the negative spillover effects of subsidies.
 However, the Agreement is limited by its incomplete form, which had to leave out norms relating to subsidies that contribute to overcapacity and overfishing, and special treatment for developing countries. In addition, the Agreement will be ineffective unless comprehensive norms on fisheries subsidies are agreed upon within four years of its entry into force, unless otherwise agreed upon by the Members. However, given that the current Agreement covers significant portion of dangerous situations in which subsidies can harm the marine environment, and that negotiations are currently underway to seek a comprehensive norm, it is possible that a comprehensive agreement could emerge that would encompass the outcomes of more than two decades of fisheries subsidy negotiations.

Trueness of five different 3D printing systems including budget- and professional-grade printers: An In vitro study

ProblemSeveral types of 3D printers with different techniques and prices are available on the market. However, results in the literature are inconsistent, and there is no comprehensive agreement on the accuracy of 3D printers of different price categories for dental applications. AimThis study aimed to investigate the accuracy of five different 3D printing systems, including a comparison of budget- and higher-end 3D printing systems, according to a standardized production and evaluation protocol. Material and methodsA maxillary reference model with prepared teeth was created using 16 half-ball markers with a diameter of 1 mm to facilitate measurements. A reference file was fabricated using five different 3D printers. The printed models were scanned and superimposed onto the original standard tesselation language (.stl) file, and digital measurements were performed to assess the 3-dimensional and linear deviations between the reference and test models. ResultsAfter examining the entire surface of the models, we found that 3D printers using Fused filament fabrication (FFF) technology −120.2 (20.3) μm create models with high trueness but high distortion. Distortions along the z-axis were found to be the highest with the stereolithography (SLA)-type 3D printer at −153.7 (38.7) μm. For the 4-unit FPD, we found 201.9 (41.8) μm deviation with the digital light processing (DLP) printer. The largest deviation (−265.1 (55.4) μm) between the second molars was observed for the DLP printer. Between the incisor and the second molar, the best results were produced by the FFF printer with −30.5 (76.7) μm. ConclusionBudget-friendly 3D printers are comparable to professional-grade printers in terms of precision. In general, the cost of a printing system is not a reliable indicator of its level of accuracy.

China's Economic Evolution: From WTO Accession to Global Leadership

This study provides a comprehensive exploration of the transformative journey of China's economic policies and global engagement from its accession to the World Trade Organization (WTO) in 2001 to the present day. The analysis spans three distinct phases: the initial shift from a centrally planned to a market-oriented system, the full integration into the global economic system marked by meticulous adherence to WTO commitments, and the subsequent era characterized by the Belt and Road Initiative and high-quality development strategies. Examining key milestones such as the establishment of free trade zones, internationalization of the yuan, and participation in significant agreements like the Regional Comprehensive Economic Partnership (RCEP) and the China-EU Comprehensive Agreement on Investment (CECAI), the study highlights China's pivotal role in shaping global economic structures. The findings underscore China's commitment to opening-up, fostering international cooperation, and contributing significantly to reshaping the global economic landscape.

Building bridges to peace: a quantitative evaluation of power-sharing agreements

Abstract Power-sharing agreements are used as a tool to reduce political violence in regions of conflict, but agreements are often followed by violence. This is due to the fact that such agreements are introduced during periods of political violence when a country is inside the conflict trap, which makes it difficult to distinguish the effect of the agreement from the political context that generates persistent political violence. In this study, we match pre-agreement conflict risk to estimate the effects of power-sharing agreements on violence using a difference-in-difference method. The results show that violence falls immediately after an agreement, with the effects strengthening over time. Comprehensive agreements tend to be particularly successful. We show that broader institutional changes that have their nucleus in the agreements are crucial elements explaining these large changes.

Quality Indicator Development for the Approach to Ineffective Esophageal Motility: A Modified Delphi Study.

Develop quality indicators for ineffective esophageal motility (IEM). IEM is identified in up to 20% of patients undergoing esophageal high-resolution manometry (HRM) based on the Chicago Classification. The clinical significance of this pattern is not established and management remains challenging. Using RAND/University of California, Los Angeles Appropriateness Methods, we employed a modified-Delphi approach for quality indicator statement development. Quality indicators were proposed based on prior literature. Experts independently and blindly scored proposed quality statements on importance, scientific acceptability, usability, and feasibility in a 3-round iterative process. All 10 of the invited esophageal experts in the management of esophageal diseases invited to participate rated 12 proposed quality indicator statements. In round 1, 7 quality indicators were rated with mixed agreement, on the majority of categories. Statements were modified based on panel suggestion, modified further following round 2's virtual discussion, and in round 3 voting identified 2 quality indicators with comprehensive agreement, 4 with partial agreement, and 1 without any agreement. The panel agreed on the concept of determining if IEM is clinically relevant to the patient's presentation and managing gastroesophageal reflux disease rather than the IEM pattern; they disagreed in all 4 domains on the use of promotility agents in IEM; and had mixed agreement on the value of a finding of IEM during anti-reflux surgical planning. Using a robust methodology, 2 IEM quality indicators were identified. These quality indicators can track performance when physicians identify this manometric pattern on HRM. This study further highlights the challenges met with IEM and the need for additional research to better understand the clinical importance of this manometric pattern.

Comparative sentiment analysis of grand renaissance dam controversy in Egyptian and Ethiopian newspapers

Through a 3-year period of content analysis, this study compares predominant sentiments, stakeholder portrayal, framing techniques, and prevailing tone in Egyptian ‘Ahram Online’ and ‘The Reporter’ Ethiopian newspaper coverage of the Grand Ethiopian Renaissance Dam (GERD) controversy. Despite the relatively extended, ongoing nature of GERD negotiations, throughout the last 3 years, 2020 – 2023, representing the time frame of the current study, the news coverage of both the Ethiopian and Egyptian media has portrayed the sentimental pillars of controversy in a contemporary manner.The results revealed that Ahram Online, the Egyptian newspaper, predominantly conveys a positive sentiment, echoing Egypt's focus on diplomacy and negotiation to resolve the Grand Renaissance Dam dispute, fostering an optimistic and cooperative tone. Conversely, 'The Reporter,' an Ethiopian newspaper, exhibits varying sentiments over time, with positive portrayals of Ethiopia's perspective on the Grand Ethiopian Renaissance Dam (GERD) and negative sentiments concerning external actors and evolving Egypt-Ethiopia tensions.Ahram Online portrays Egypt as advocating for its water rights and comprehensive agreements, emphasizing diplomacy and casting Egypt positively. 'The Reporter' presents Ethiopia as dedicated to its development, emphasizing the GERD's importance while critically covering external stakeholders.Both newspapers employ framing techniques. Ahram Online emphasizes cooperation, regional stability, and responsible water use, framing the GERD issue positively. 'The Reporter' highlights Ethiopia's historical challenges and the urgency of the GERD project while critically framing external actors.Al-Ahram's tone remains optimistic and cooperative, emphasizing diplomatic solutions. 'The Reporter' exhibits varying tones, including optimism, urgency, skepticism, and negativity, reflecting Ethiopia's perspective and concerns about external actors and evolving tensions.

The rise and fall of the EU-China Comprehensive Agreement on Investment: ‘open strategic autonomy’ in action

ABSTRACT (Open) strategic autonomy (OSA) has quickly become the dominant concept in European Union (EU) trade policy strategy. This article aims to better understand how the concept plays out in policy practice by focusing on its discursive use in the rise and fall of the EU-China Comprehensive Investment Agreement (CAI). We start from the assumption that OSA as an ‘empty signifier’ is sufficiently malleable to account for diverging interpretations. Building on existing literature, we then construct an analytical framework that distinguishes between trade policy paradigms. Subsequently, we utilize Fairclough & Fairclough’s ‘scheme of practical argument’ to analyze how the three signifiers of OSA – openness, sustainability and assertiveness – are connected in EU trade policy debates for or against CAI between May 2020 and September 2021. Our findings reveal that the concept of OSA can be utilized in both economics and foreign policy oriented arguments. While the Trade instead of Foreign Policy’ (TiFP) paradigm was initially co-opted by the neoliberal paradigm, the Trade steered by Foreign Policy (TsFP) paradigm became gradually more dominant. These findings also contribute to explaining, respectively, the rise and fall of the CAI.

The 21st Century Israel-Palestine Conflict Over Jerusalem and its Peace Processes

Jerusalem is a depiction of the Israeli-Palestinian conflict's national politics and contrasting identities. The continuous rise in violence, with its devastating effect on peace and security prompts the examination of the conflict, various peace processes and the status of Jerusalem. The major objectives of this paper are to examine the Israel-Palestine conflict over Jerusalem in the 21st century and analyse the status of Jerusalem and different peace talks through external mediation and intervention. The theory of structural realism was adopted for this study; which, concerning the conflict over Jerusalem, emphasises that war is a significant, and fundamental instrument of change in international affairs. Secondary data was used in this paper, by reviewing and analysing data gathered from scholarly publications, journals, articles, and online materials. The paper finds an intensified increase of violence between Israel and Palestine, especially regarding the status of Jerusalem and Palestine as an independent state. The paper concludes that despite numerous peace processes and diplomatic efforts, a lasting resolution has remained elusive. The failure to achieve a comprehensive agreement stems from a combination of factors, including conflicting narratives, incompatibility of goals, deep-rooted mistrust, geopolitical complexities, and the influence of external actors. Peace, stability, and acceptable status of Jerusalem can only be initiated and resolved solemnly between Israel and Palestine, but until then, neither the status of Jerusalem nor Palestine would be defined.

The Impact of EU and China Comprehensive Agreement on Investment on the Prospects of China's Air Transport Industry

EU and China Comprehensive Agreement on Investment (CAI) is aimed at setting up a bilateral investment system between China and Europe. Although there are few provisions about air transportation in CAI, it is undoubted that the signing of CAI will have a certain influence on the development of Chinese air transportation industry. This paper makes an analogous analysis of the development process of Chinese and American air transport market. The results show that the aviation market between China and Europe has great potential for development. The study has suggestive significance for Civil Aviation Administration to formulate and enhance the comprehensive strength of China's air transport and innovate policy management.

COMPARATIVE ANALYSIS OF REGIONAL TRADE BLOCS

This research paper investigates the impact of regional trade blocs (RTBs) on global trade and economic growth, adopting a comparative perspective. Regional trade agreements (RTAs) have gained significant prominence in the global economy due to their role in promoting trade liberalization and economic integration among member nations. This study aims to assess the potential for multilateral liberalization within these blocs and examines how political and ideological differences influence the effectiveness of RTBs. Additionally, it explores the consequences of the proliferation of RTAs on international trade dynamics and their broader economic implications. The analysis begins by examining the effects of RTBs on global trade. The study compares the trade performance of RTB member countries with non-member countries to assess the extent to which RTBs contribute to trade expansion. Furthermore, the research investigates the impact of RTBs on economic growth. The economic integration fostered by RTBs can lead to increased investment flows, technology transfer, and productivity gains. It considers the potential spillover effects of RTBs on non-member countries, as increased regional integration may create both opportunities and challenges for economies outside the bloc. The analysis also delves into the complexities of multilateral liberalization within RTBs. While RTBs aim to promote trade liberalization among member countries, the presence of political and ideological differences can hinder the achievement of comprehensive agreements. The study explores the challenges faced by RTBs in reaching consensus on sensitive issues such as agriculture, intellectual property rights, and services trade. It examines the role of political dynamics and power asymmetries within RTBs in shaping the outcomes of negotiations.